Patient Education Library | Carpal Tunnel Syndrome
Understanding Carpal Tunnel Syndrome
Pain, numbness, and tingling in your hand may be from carpal tunnel syndrome (CTS). CTS happens when the area around the main nerve to your hand is too tight. The nerve is called the median nerve, and the small space in your wrist where it passes is called the carpal tunnel. Carpal tunnel syndrome may be a temporary condition that completely resolves or it can persist and progress.
What is the Carpal Tunnel?
The carpal tunnel is a narrow passageway on the palm side of your wrist made up of bone and ligaments that connects the forearm to the hand. The median nerve which provides over half of the hand with its sense of touch runs along this passageway along with tendons to the fingers and thumb. The canal is narrow, and when any of the tendons passing through it swell or degenerate, the median nerve can become entrapped, pinched, or compressed resulting in numbness, tingling, weakness, or pain in the hand, called carpal tunnel syndrome.
Causes & Risk Factors
Women are three times more likely than men to get carpal tunnel syndrome. This may be due to the fact that women have smaller wrists (and carpal tunnels) than men, and compression can more easily occur. For most patients, the cause of their carpal tunnel syndrome is unknown. Diseases or conditions that may increase the chances of developing CTS include:
- Edema, increased fluid within carpal tunnel due to tissue injury, congestive heart failure, or pregnancy
- Trauma including fractures, dislocations of the wrist, displaced bones or spurs disrupt the carpal tunnel
- Systemic disorders including diabetes, rheumatoid arthritis, hypothyroidism, amyloidosis, and vitamin B12 deficiency
Repetitive and forceful grasping with the hands or repetitive bending of the wrist as well as inherited small bone structure may also lead to increased incidence of CTS.
Carpal Tunnel Syndrome & Pregnancy
Studies show that carpal tunnel syndrome affects more than half of moms-to-be. Pregnancy swelling puts pressure on the median nerve in the wrist. Additionally, pregnant women are often less active, resulting in less circulation to to hands and other extremities. Expecting women, especially those who work at computers, may begin to notice an uncomfortable tingling, pain, burning and numbness in the wrists, hands and fingers usually in the second or third trimester, and most often at night. To minimize the risks of getting carpal tunnel while pregnant, expecting moms should try to minimize time spent doing intensive manual tasks such as typing and texting. In most cases, CTS symptoms dissipate within three months of your baby’s birth. By then, your hormone and body fluid levels will return to normal.If symptoms of CTS symptoms don’t go away after delivery, be sure to let your physician know.
Carpal tunnel syndrome develops slowly. People with CTS initially feel numbness and tinging of the hand, particularly in the thumb, index, middle, and thumb side of the ring fingers, or palm. Other initial CTS symptoms may include:
- Night pain relieved by exercising or shaking of the hand
- Daytime pain or tingling when trying to perform routine tasks (driving a car, reading a newspaper, holding your phone)
- Hands feel clumsy
At first, symptoms of carpal tunnel syndrome come and go, but as the condition worsens, symptoms may become constant. As CTS progresses, you may notice weakness in the thumb and first two fingers that makes it hard to make a fist or grasp objects, leading to frequent dropping of objects from the hand. Other later symptoms may include:
- A burning sensation and/or cramping and weakness of the hand
- Sharp, shooting pains in the forearm, arm, and shoulder
In more severe cases, you can lose muscle at the base of your thumb. Or you may no longer be able to tell hot from cold just by touch.
Carpal Tunnel Syndrome Prevention
Carpal tunnel syndrome can be difficult to prevent, but there are things you can do to minimize your risks. A few methods to help prevent CTS include:
- Monitor and properly treat medical conditions linked to carpal tunnel syndrome
- Maintain a healthy lifestyle
- Lose weight if you’re overweight- Obsesity can slow down the speed of nerve messages to the hand
- Don’t smoke (It interferes with blood flow and makes CTS worse)
- Take regular breaks from repeated hand movements to give your hands and wrists time to rest
- Improve your body mechanics and posture at your work station
- If you use a keyboard a lot, adjust the height of your chair so that your forearms are level with your keyboard and you don’t have to flex your wrists to type
- Stretch your hands, fingers, and wrists often by rotating them in circles and flexing and extending your palms and fingers
- Keep your hands warm to prevent stiffness.
Expert Treatment for carpal Tunnel Syndrome at The NeuroMedical Center
Early diagnosis is important in managing CTS. At The NeuroMedical Center, there are several tests your doctor will perform to diagnose, or rule out, carpal tunnel syndrome including a nerve conduction test or electromyography (EMG). The ultimate goal of treatment is to decrease the pressure on the median nerve. Neurosurgeons and Interventional Pain Specialists at The NeuroMedical Center specialize in treating carpal tunnel with both surgical and non-surgical options. Non-operative measures that will reduce edema and inflammation of tissues:
- Time off/rest
- Wrist brace/splint
- Anti-inflammatory medication and diuretics
- Modified hand activity and work environment
- Steroid Injections
- Treatment of underlying disease
In severe cases, surgery is needed to make the carpal tunnel symptoms go away completely. Treatments for carpal tunnel are performed in the award-winning Spine Hospital of Louisiana. We also offer an expert team of occupational and hand therapists who will provide one-on-one therapy sessions to improve strength and flexibility in your hands after a carpal tunnel procedure.